Certainly I grew up the child who was often correcting others grammar silently within my mind, and even bonded with a few friends over this obsessive-compulsive habit, so there is potential that I am a tad more passionate about the writing expectations I have for my students than the average professor. I've also been the homeschool mother who titles grammar class as dating 101. Good writing skills is a basic life skill in my mind, yet, for reasons I will explain, I do believe mastering those skills in graduate school is just as important for nurse practitioners as any other clinical skill set we may acquire.
It is true that everyone enters graduate school with a different skill set when it comes to writing. It comes easier to some than it does to others. No one really enjoys being a novice either, and it can be easy to rationalize that APA details are unimportant. This is likely not what you returned to school to master, right?
The reality is that APA isn’t just about proving you didn’t steal someone else’s work or if you know how many spaces to put after a period. It’s about writing and sharing your expertise in way that gives credibility to your argument. Whatever motivated you to return to graduate nursing school, I suspect it wasn’t your hopes for wealth or fame. More likely you have a passion, something you hope to invest in and create real change. You want to make an impact and truly help people.
Healthcare is an exceedingly hard infrastructure to permeate. Those making the big decisions are often not the ones working in the frontline. If you want to accomplish whatever it is you’ve set your mind to, making this endeavor worth it, then you must learn how to gather your evidence, think critically and independently, and articulate innovative ideas that are well supported and credible.
While I would love to tell you the road ahead is paved with beautiful roses, the reality is that nurse practitioners often garnish far less respect for their roles than is deserved. If I am being truly honest, many nurse practitioners endure a great deal of hostility and struggle with consistent efforts to dehumanize their presence within the medical team.
Nurse practitioners have to work harder to earn a seat at the table. I wish I could share with you the number of times I’ve been in influential meetings where a physician or administrative leader hushed a nurse practitioner making the assumption they were less educated and had nothing of importance to share. Often they receiving condescending reprimand because too often we speak from our hearts, with experience gained working one-on-one with the client, but not with a scholarly understanding of the literature. We don’t speak the language that program directors, investors, third party payers, liability underwriters, malpractice attorneys, or political leaders want to hear.
However, I've also been part of a number of circumstances in which not on person at the table had any deeper understanding of a critical issue than mere Cliff Notes if you will, and in my career, I have watched this lack of truly understanding the literature create profound practice changes that have yet to be corrected. A thorough understanding of the literature is what will enable you to educate your clients with confidence about what's happening in their bodies to help galvanize their empowerment, and truly advance the profession.
Understanding how to dig into scholarly work, think on it, and craft your own perspective and as important, be able to articulate that in a way the profession understands and values, means you must master APA. You must understand why citations are important, as it is not just about giving credit to a previous author. It is about validating your points, demonstrating that your argument is worthy of being considered, giving your reader a place to go for further study, and for documenting the history and projection of this innovative idea you have so you too, can be somewhat self-aware of your own expertise and ignorances.
Too often nurses speak in absolutes, but a #scholar understands that proof and science are oxymorons. Proof only exists in mathematics and logic. Science is empirical. We have evidence, not proof. We have more and better evidence, and less and worse evidence. Scientific knowledge is tentative and provisional, but not final. We have best explanations and these may change tomorrow.
Scholars recognize real scientists from the hacks and wannabes because scientists never use the words “scientific proofs.” Anyone using “proof,” “prove,” and “proven” are not thought to have any credibility. Science that may seem to be as solid as the desk you sit at may prove tomorrow to be all wrong, albeit even if that may be very, very, very, very unlikely. We have to be open to the idea that science evolves as do our perceptions of that science and that application in our lives. We can not speak in absolutes, and because of this, when we provide these #citations at the close of our sentences, we are demonstrating to the reader the basis of our argument. When someone challenges us we can offer the merit of our claims and the depth of our study.
When an author cites a conversation with their sales representative as their reference, and I have found this to be true of highly respected authors in our profession, then you have full understanding of the underpinning of their argument. They may be persuasive but they are not evidence-based. It is alarming how many issues you may feel strongly that you are well-educated only later to learn that all you knew was only theory and in fact, the profession is only in theoretical stages. When someone provides five citations for a single statement and offers a position statement from a professional organization or recognizes the level of evidence they cite, then you know it’s time to listen up. These are the people whose voice is heard when elbows are rubbing at the table.
I know this is a big task. Most of you, as graduate students, are overworked and far underpaid. You are exhausted emotionally and physically, but the reality is that you are paying good money to be educated and as your professor, I am committed to making sure you get from me what you've invested. Not all professors will read every page of your work and certainly not every word. They get paid the same if they push you along with a sentence or two of critique, or if they push you to get serious and raise your own standards.
I love this profession and it is an honor to be called to assist in the healing of others. We have many players in the game, not all for authentic reasons. Nurses have to be sharp to create change and sustain those efforts. Don’t begrudge my fussing over the details because when you present yourself to those who want to discredit you, you’ll be well-prepared. You’ll have earned that seat at the table.
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